Blood in Stool: Should You See a Doctor or Wait and Observe?

Blood in the stool?

I previously had irritable bowel syndrome, and recently, due to stress, I've experienced a recurrence along with constipation (occasionally, my stool has been very hard, and I've noticed a small amount of blood on the toilet paper).
Yesterday, I suddenly had a strong urge to have a bowel movement, but I held it for over an hour due to other commitments.
After finally going, I noticed that the entire piece of toilet paper was stained with blood mixed with stool for the first time.
After wiping two more times, the blood decreased, but there were still traces of blood floating in the toilet.
Should I see a doctor, or is it okay to just observe the situation for now?

Niming, 20~29 year old female. Ask Date: 2017/07/31

Dr. Ke Fangxu reply Surgery

In this situation, it is recommended to maintain a light diet and a good daily routine.
Spicy, irritating, and greasy foods should be avoided.
If symptoms persist without improvement, you may consult a physician for medication or undergo a colonoscopy.

Reply Date: 2017/07/31

More Info

When it comes to blood in the stool, it is important to take this symptom seriously, especially given your history of irritable bowel syndrome (IBS) and recent stress-related flare-ups. While IBS can cause changes in bowel habits and may lead to minor bleeding due to irritation or hemorrhoids, the presence of blood—especially in larger amounts or mixed with stool—should not be ignored.

Understanding the Symptoms
1. Nature of the Blood: The fact that you observed blood on the toilet paper and mixed with your stool is significant. If the blood is bright red, it typically indicates that the source of bleeding is closer to the rectum, which could be due to hemorrhoids, anal fissures, or other conditions. Darker blood, on the other hand, may suggest bleeding from higher up in the gastrointestinal tract, such as the colon or small intestine.

2. Associated Symptoms: You mentioned experiencing constipation and hard stools, which can lead to straining during bowel movements. This straining can cause small tears in the anal area (fissures) or exacerbate hemorrhoids, both of which can result in bleeding. However, if you experience additional symptoms such as abdominal pain, changes in bowel habits, unexplained weight loss, or fatigue, these could indicate a more serious condition.

When to See a Doctor
Given your situation, it is advisable to consult a healthcare professional rather than just observing the symptoms. Here are some reasons why:
- Persistent or Worsening Symptoms: If the bleeding continues, increases in volume, or is accompanied by other concerning symptoms, it is crucial to seek medical attention.

- History of Gastrointestinal Issues: Your history of IBS and recent stress-related flare-ups may complicate your condition. A healthcare provider can help determine if the bleeding is related to IBS or if there is another underlying issue that needs to be addressed.

- Rule Out Serious Conditions: While many causes of blood in the stool are benign, it is essential to rule out more serious conditions such as diverticulosis, inflammatory bowel disease (IBD), or colorectal cancer, especially if you are over 50 or have a family history of gastrointestinal diseases.

What to Expect at the Doctor's Visit
When you see a doctor, they will likely perform a thorough evaluation, which may include:
- Medical History and Physical Examination: Discussing your symptoms, medical history, and any medications you are taking.

- Diagnostic Tests: Depending on the initial assessment, the doctor may recommend tests such as a stool test, colonoscopy, or imaging studies to identify the source of bleeding.

Conclusion
In summary, while it is possible that the blood in your stool is due to minor issues related to your IBS, it is essential to err on the side of caution. Given the nature of your symptoms and your medical history, it is advisable to see a doctor for a thorough evaluation. Early diagnosis and treatment can help prevent potential complications and provide peace of mind. Remember, your health is paramount, and addressing these symptoms promptly is the best course of action.

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